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          Institute: MPI für Herz- und Lungenforschung (W. G. Kerckhoff Institut)     Collection: Yearbook 2016     Display Documents



ID: 723934.0, MPI für Herz- und Lungenforschung (W. G. Kerckhoff Institut) / Yearbook 2016
The prognostic relevance of oxygen uptake in inoperable chronic thromboembolic pulmonary hypertension
Authors:Richter, M. J.; Pader, P.; Gall, H.; Reichenberger, F.; Seeger, W.; Mayer, E.; Guth, S.; Kramm, T.; Grimminger, F.; Ghofrani, H. A.; Voswinckel, R.
Date of Publication (YYYY-MM-DD):2015-10-16
Title of Journal:Clin Respir J
Audience:Not Specified
Abstract / Description:BACKGROUND: Patients with chronic thromboembolic pulmonary hypertension (CTEPH) present with a decreased oxygen uptake, however, the prognostic relevance of oxygen uptake (VO2 ) in inoperable CTEPH is unknown. METHODS: Patients with inoperable CTEPH were retrospectively analyzed. All patients were assessed by means of right heart catheterisation and cardio pulmonary exercise testing in semisupine position with a 30 Watt increment step-protocol. RESULTS: One-hundred and fifty-one patients (82 female (54.3%), mean age 61 +/- 12.4 years) presented with a mean pulmonary arterial pressure of 40.2 +/- 14.2 mmHg and pulmonary vascular resistance (PVR) of 641.9 +/- 374.8 dyne *s/cm5 . The peak VO2 (mean 13.1 +/- 4.5 mL *kg-1 *min-1 ) was measured at initial referral. Over a follow-up of up to 10 years (mean 4.41 +/- 2.57 years), 31 patients had died. Patients with a baseline peak VO2 >/= 10.7 mL *kg-1 *min-1 [area under the receiver-operating characteristic curve (AUC) = 0.728, P = 0.001] had better survival than those with a peak VO2 </= 10.7 mL *kg-1 *min-1 using Kaplan-Meier analysis (88.8% vs 60.1%; log rank P = 0.001). Adjusting for age, gender and PVR, multivariate analysis identified peak VO2 as a predictor of mortality [hazard ratio (HR): 2.78, 95% CI 1.01-7.63, P = 0.047]. In addition, peak VO2 failed as an independent prognostic factor in a stepwise multivariate model including all variables significant in the univariate analysis. CONCLUSIONS: In patients with inoperable CTEPH the peak VO2 is a significant predictor of survival, when adjusting for age, gender and PVR. However, peak VO2 failed as an independent prognostic factor when correcting for all significant baseline variables, which is limiting the clinical usability.
Free Keywords:cardio pulmonary exercise testing - chronic thromboembolic pulmonary hypertension; - oxygen uptake - prognostic factor - survival
External Publication Status:published
Document Type:Article
Communicated by:n.n.
Affiliations:MPI für physiologische und klinische Forschung
External Affiliations:Universities of Giessen and Marburg Lung Center (UGMLC), Member of the German Center for Lung Research (DZL). Department of Pneumology, Asklepios Hospital, Munich-Gauting, Germany. Department of Thoracic Surgery, Kerckhoff Heart, Rheuma and Thoracic Center, Bad Nauheim, Germany. Department of Internal Medicine, Health Center Wetterau, Friedberg, Germany.
Identifiers:ISSN:1752-699X (Electronic) 1752-6981 (Linking) %R 10.1111/crj.12399
URL:http://www.ncbi.nlm.nih.gov/pubmed/26470843
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